Our office hours are from Monday to Friday 8am - 5pm.
Tel/Fax : 043 743 8804
31 St James Road
What are our hours of opening?
Our practice is open for bookings Monday to Friday 08h00 to 17h00, except for Fridays when we close at 16h00. I am generally available after hours during the week on my cellphone but there is an ENT call roster for after hours emergencies during the week, over weekends, and on public holidays. This roster can be accessed by calling the St Dominic’s ER and requesting the after hours specialist on call. During work hours we prefer you to call the practice number for appointments and advice and not me directly on my cellphone as I am often in consultation or in surgery.
Do I need to see a specialist? Should I contact my GP first?
Most illnesses are best managed by your family doctor. They are the best people to decide if and which specialist you should see. However conditions such as deafness or discharging ears will often be easier for the ENT to sort out primarily. If in doubt ask your GP first. Patients with established conditions that usually need specialist care are often better off coming to see us directly. However there are quite a few medical plans that require you to obtain authorization through your GP before seeing a specialist. Our admin staff will be able to advise you in this regard.
Which children need grommets?
Grommets are indicated for recurrent infections of the ear or when middle ear fluid persists causing deafness. Occasional episodes of infection are often better treated with antibiotics. We will be able to advise what is best. The two main peaks for requiring grommets are during the teething years and then in older children from four to seven years of age for glue ear conditions.
Will my child be able to swim once he has grommets?
In general yes. With the younger ones they often need no added protection as their narrow ear canals and lack of diving under water prevents water entry. For older children who swim a lot it is often better to use a piece of prestick or a commercial plug together with a swimming cap to prevent water entry.
My child has had so many ear infections could he become deaf?
This is one of the most commonly asked questions and the greatest fear of many parents. Happily permanent deafness in children following middle ear infections is rare, even in children who have had many episodes of painful or discharging ears. Prompt treatment of ear infections with antibiotics and the appropriate use of grommets have greatly reduced the incidence of long term deafness in adulthood.
When do I need to have my child’s tonsils or adenoids removed?
The most common indication for tonsillectomy is recurrent episodes of tonsillitis. We usually wait till the age of about three as some children might outgrow the problem once they have finished teething and the larger size of the older children means that they usually cope better with the operation than those who are only one or two years of age. From an immunity point of view the tonsils have done most of their work by three years old and are generally no longer needed.
If your child has airway obstruction in the form of severe snoring or even with apnea (temporary pauses in breathing due to severe snoring) then tonsillectomy and adenoidectomy will usually bring immediate relief from what is a potentially dangerous situation. This surgery may be performed at as young as eighteen months of age. For younger children removing the adenoids without tonsillectomy often helps to relieve snoring.
Is it dangerous to have my tonsils removed as an adult?
No it is not. It is more painful than when you are a child but the complication rate is about the same for children and adults. Overall tonsillectomy is a very safe procedure to undergo. Tonsillectomy is still the most common and successful operation performed by ENT Surgeons. It remains a painful for one to two weeks after they are removed but methods of pain relief have advanced significantly in recent years. There is no painless way to remove the tonsils. The most appropriate surgical technique is used according to age and operating conditions.
Do tonsils grow back after being removed?
Regrowth of tiny pieces of tonsil tissue is not uncommon despite a very thorough tonsillectomy. However it is most unusual that these ever cause symptoms; therefore it is rare for anyone to have to undergo this procedure twice.
How do I know when I need a hearing aid?
If you feel you have poor hearing this is always a good time to get an opinion from an ENT. We are able to see if there is any treatable cause, do the hearing test, and give good advice as to whether you will actually wear the hearing aid or not. Many hearing aids are purchased but then not used regularly by people for a variety of reasons. We are generally able to help select suitable candidates for hearing aids. We are also able to refer you to the appropriate audiologist or acoustician to have the hearing aids fitted.
How effective is sinus surgery?
Sinus surgery is very effective when performed for the right indications. That includes recurrent and ongoing sinusitis, nasal polyposis and for the acute complicated sinus cases. It is not always effective for the long term relief of facial pain as many cases of facial pain are due to symptoms relating to the tension headache spectrum of conditions. Nasal blockage is very effectively dealt with by intranasal surgery. We can advise you as to whether surgery will be beneficial to you or not.
I have a lump in my throat. How do I know it is not cancer?
The sensation of a lump in the throat is common and is usually related to stress and tension or acid reflux or a combination thereof. It is very rare for this to be a sign of throat cancer. However for peace of mind it is often better if I have a look with diagnostic instruments. More concerning is persistent hoarseness which always needs to be checked out by us if it lasts more than a few weeks. Throat symptoms in someone who has smoked quite heavily in their lives should always be investigated.
Is it dangerous for my small child to undergo a general anesthetic for an ENT procedure?
Modern anesthetics for children are extremely safe. Problems relating to the anesthetic are very rare indeed. Recovery room staff at Life St James are highly experienced at ensuring a safe awakening for small children after the anesthetic. In all my time working in East London I have not had one patient suffer any significant anesthetic related complication.
I am suffering from dizziness. Should I go directly to the ENT?
We are very experienced with patients who have vertigo (spinning sensation accompanied by nausea). However many patients have other general causes for feeling dizzy which are not related to ear conditions and it is therefore advisable to see your GP first to be assessed. If you have an established vertigo condition and are known to us it is probably better to come directly to us if it recurs.
Should I see an ENT to have wax removed from my ears?
Most wax is removed by GPs and clinic nursing sisters by syringing. In a few cases wax may be very hard to clear and then it is advisable to have your ears cleared by an ENT. If you have had previous problems or operations on the ears it is best to see the ENT directly. It is best to avoid ear buds as they compact wax in the ear canal and can make removal very difficult. Commercial drops that you pour into your ear to try and remove wax have a very low rate of success.
MBChB MMED (Stell) FCS(SA)ORL
I work in all areas of the ENT field and as with most ENT specialists spend much of my operating time removing tonsils and adenoids and inserting grommets. I also have special interests in middle ear surgery, endoscopic sinus surgery and have had great success with diagnosing and treating painful conditions of the ear as well as vertigo conditions. More recently exciting improvements had been made with the improvement of implantable hearing devices and I expect this to form a growing part of my practice.
Having qualified with my medical MBChB degree at UCT I worked further in fields of pediatrics, respiratory medicine and cardiology and radiology at Red Cross Children’s hospital and Groote Schuur Hospital before commencing training in ENT at Tygerberg hospital through the University of Stellenbosch. Tygerberg hospital is well grounded in surgery of the ear, head and neck surgery, and has a long established endoscopic sinus surgery unit.
Since qualification I have travelled to attend surgical clinics in Germany, Austria, and Switzerland and have attended many courses and congresses presented in South Africa under the supervision of world authorities.
The field of ENT has advanced greatly since the last millennium. Endoscopic sinus surgery has evolved with the image of the operating field now projected onto a high definition screen, rather than the surgeon looking directly through the endoscope. This improves visibility enormously and increases safety. It has always been my practice to choose patients for sinus surgery carefully. Not all patients with sinus symptoms will benefit from surgery and experience is important when making decisions in this regard. Many patients have their symptoms alleviated by appropriate medication. Regular attendance of refresher courses and surgical skill workshops has been vital to stay abreast of developments in both the medical and surgical side of management of diseases of the nose and sinuses.
Middle ear surgery principles have been well established since the advent of the operating microscope in the 1960s. Significant advances have been made with regards to achieving lasting hearing improvement and this has become the goal of all ear operations. The endoscope is now also used in many forms of middle ear surgery but has yet to achieve as reliable and safe results as with the operating microscope. The long hours that I spent in the temporal bone laboratory at Tygerberg Hospital have stood me in good stead with the various complicated middle ear operations that we frequently perform as ENT surgeons. Cochlear implantation for profound deafness has become a more commonly performed procedure than in the past, however patients are usually referred to major center’s for this. Major growth is happening currently in the field of implantable hearing devices for moderate and unilateral deafness and this technology is now available in East London.
Tonsillectomy has been around for over two thousand years and although surgical techniques have evolved it remains a painful operation to recover from irrespective of which method is used. It is my practice to use the method that is the most appropriate for you and which has the lowest complication rate. If you undergo this operation we will supply you with the best pain relieving medication that is available and you will recover. Tonsillectomy remains the most successful operation that we perform. Without your tonsils you will not get tonsillitis again.